Organization
LABORATORIO CLINICO FAJARDO, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. WANDA IVETTE AVILES MT (OWNER-PRESIDENT OF CORP-LAB. SUPERV)
(787) 863-5952
Entity
Organization
Contact information
Practice address
40 CARR 194, STE. 100 FDO. CINEMA BLDG, FAJARDO, PR 00738-2940
(787) 863-5952
(787) 863-3116
Mailing address
40 CARR 194, SUITE 100, FAJARDO, PR 00738-2940
(787) 863-5952
(787) 863-3116
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
1106
PR
Other
Enumeration date
04/27/2006
Last updated
12/15/2022
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